Outpatient medicine: Do general practitioners and specialists need a priority lane concept for privately insured patients?

Data, facts and instruments on the German health system

What is at stake

Some general practitioners and specialists are convinced that it is not necessary to differentiate between patients with health insurance and those with private health insurance within the scope of the practice management services, even if the quality of medical care is the same. Another part works with priority lane approaches, even if medical professional organisations dispute this fact. How do the results compare?

The Equal Treatment Result

The results of the IFABS Business Comparison Tracker© for GP, specialist and dental practice management show that an Equal Treatment approach for SHI and privately insured patients (waiting time and comfort, appointment allocation, services etc.) leads to very different assessments of the quality of care. If one compares the information of the practice visitors on their requirements and their satisfaction and forms the Patient Care Quality Score (PCQS), the following results are obtained

in practices with the equal treatment approach, the average score for SHI patients is 57%,
for private patients, the average score is only 39%.

The Priority Lane Effect

If a priority lane approach is systematically pursued, the private patient score moves to a level of 72% with a parallel almost unchanged score by the statutorily insured. The time series analysis shows that the requirements of members of private health insurance funds have basically increased significantly in recent years, but at the same time the satisfaction of this target group, which is important for general practitioners and specialists, has decreased. Thus, the necessity of using priority lane concepts within the framework of practice management arises directly from patient behaviour.

Interested practice owners can